Pulmonology Coding Alert
94060 Covers More Than You Think
South Dakota Subscriber
Answer: If your physician performs a bronchospasm evaluation to determine the patient's responsiveness of treatment, you should report 94060 (Bronchodilation responsiveness, spirometry as in 94010, pre- and post- bronchodilator administration), which includes the spirometry measurements both pre- and post- bronchodilator administration.
Carriers do not consider the cost of the bronchodilator as part of the payment for 94060. CPT suggests that you report 99070 (Supplies and materials [except spectacles], provided by the physician over and above those usually included with the office visit or other services rendered [list drugs, trays, supplies or materials provided]) or the appropriate drug code.
If you report a drug code instead, you should choose a code from HCPCS that identifies the specific drug and amount the physician administered during the evaluation. For example, if the physician administers Albuterol, you may select the most appropriate code (such as, J7613, Albuterol, inhalation solution, administered through DME, unit dose, 1 mg), depending on the specific form and dose the physician administers.
But if the patient has an acute exacerbation of asthma (493.02, Extrinsic asthma; with [acute] exacerbation) to which the physician needs to administer a bronchodilator, you should report 94640 (Pressurized or nonpressurized inhalation treatment for acute airway obstruction or for sputum induction for diagnostic purposes [e.g., with an aerosol generator, nebulizer, metered dose inhaler or intermittent positive pressure breathing [IPPB] device]) in addition to the appropriate J code representing the drug.
If the physician demonstrates and/or evaluates the patient administration of the drug, you should consider the demonstration/evaluation a component of 94640. You should not report the demonstration/evaluation separately.
Pulmonology Coding Alert
- Don't Let X-Ray Reread Rules Turn You
Learn when to report modifiers -26 and -77 with 71010
Even if your physician orders and [...] - Modifier Tip:
Remember to Use -26 for Interpretation and Report
And don't overlook location of test administration to increase coding accuracy
If you find appending modifiers [...] - Clip and Save:
Follow This Modifier -26 and -TC Decision Matrix to Nail the Correct Code Every Time
Find the right code based on who, what and when
Walk your way up the ladder [...] - Heed Warnings to Avoid Common Pneumonia Coding Snafus
Scan the note for dx test details before you assign 480-486
Turn those pneumonia frowns upside [...] - You Be the Coder:
Pay Attention to 'T' Status With 94760
Question: Our technicians conduct oxygen shunt studies in which they give the patient 100 percent [...] - Reader Questions:
Dx Determines Lower Lung Infection
Question: Would you please tell me the code for lower respiratory infection?
Maryland Subscriber Answer: Unlike [...] - READER QUESTIONS:
94060 Covers More Than You Think
Question: I know that CPT changed 94664 to demonstrate and instruct the use of bronchodilators. [...] - READER QUESTIONS:
Do 99070 and Medicare Mix? Maybe Not
Question: Would you please explain the basics of reporting code 99070?
Maryland Subscriber Answer: You should [...] - READER QUESTIONS:
Consider NPPs for Counseling Services
Question: Should we consider time as a factor when billing for educational/counseling services that someone [...] - READER QUESTIONS:
Previous Hospital Care May Affect E/M Reporting
Question: A provider insurance representative recommended at an in-house seminar that when our pulmonologists see [...]
